改良PVP方法治疗中老年胸腰椎体转移瘤骨折的临床疗效分析
摘要
目的探讨改良椎体成形术(percutaneous vertebroplasty,PVP)方法治疗中老年胸腰椎体转移瘤骨折的临床效果及安全性。方法采用随机对照研究,收集2012年10月至2014年10月在我院住院治疗中老年胸腰椎体转移瘤骨折患者60例,随机分为2组,治疗组30例,采用改良PVP方法;对照组30例,采用传统PVP手术方法,观察2组患者治疗前后疼痛视觉类比评分(VAS)、术中骨水泥使用量、手术时间、器械花费等情况。结果 2组患者PVP技术操作成功率均为100%。治疗组每节椎体平均手术时间(21.89±3.48)min,对照组为(45.75±5.42)min,2组患者每节椎体平均手术时间差异有统计学意义(P<0.05);治疗组每节椎体注入骨水泥(2.35±0.46)ml,对照组为(3.87±0.67)ml,2组患者每节椎体注入骨水泥量差异有统计学意义(P<0.05);术后第3天,治疗组VAS评分(3.67±0.43)分,对照组为(3.54±0.49)分,差异无统计学意义(P>0.05)。结论改良PVP治疗方案不仅可以有效缓解患者临床症状,减少PVP相关并发症的发生,同时缩短了手术操作时间、简化了手术操作步骤,节约治疗费用,是治疗中老年胸腰椎体转移瘤骨折安全、有效、可行、值得推广的方法。
引文
1 Fernando RS,Alicia SC,Luis GL,et al.Comparative review of vertebroplasty and kyphoplasty.World J Radiol,2014,6:329-343.
2 Ruiz Santiago F,Santiago Chinchilla A,Guzmán L,et al.Comparative review of vertebroplasty and kyphoplasty.World J Radiol,2014,6:329-343.
3 王翀,李京,田征,等.经皮椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的Meta分析.中国矫形外科杂志,2014,22:493-495.
4 Han S,Park HS,Pee YH,et al.The clinical characteristics of lower lumbar osteoporotic compression fractures treated by percutaneous vertebroplasty:a comparative analysis of 120 cases.Korean J Spine,2013,10:221-226.
5 徐荣明,廖旭昱.合理运用椎体成形术与后凸成形术.中国骨伤,2010,23:723-725.
6 王建儒,张奎渤,刘辉,等.经皮椎体后凸成形术术中不同辐射防护距离的对比研究.中国脊柱脊髓杂志,2014,24:417-419.
7 Baroda G,Crookshank M,Bohner M.High-viscosity cement significantly enhances uniformity of cement filling in vertebroplasty:an experimental model and study on cement leakage.Spine,2006,31:2562-2568.
8 Lee BJ,Lee SR,Yoo TY.Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate:a case report.Spine,2002,27:419-422.
9 Legroux-Gerot I,Lormeau C,Boutry N,et al.Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.Clin Rheumatol,2004,23:310-317.
10 Patel AA,Vaccaro AR,Martyak GG,et al.Neurologic decit following percutaneous vertebral stabilization.Spine,2007,32:1728-1734.
11 Harrington KD.Major neurological complications following percutaneous vertebroplasty with polymethylmethacrylate:a case report.J Bone Joint Surg Am,2001,83:1070-1073.
12 Lim SH,Kim H,Kim HK,et al.Multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty.Eur J Cardiothorac Surg,2008,33:510-512.
13 Son KH,Chung JH,Sun K,et al.Cardiac perforation and tricuspid regurgitation as a complication of percutaneous vertebroplasty.Eur J Cardiothorac Surg,2008,33:508-509.
14 陈惠国,张喆,梁海萍,等.椎体后凸成形术治疗骨质疏松性椎体骨折中期疗效及并发症的临床观察.中国骨伤,2010,23:743-745.
15 吴耀,王峰,周建强,等.经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体骨折的临床疗效分析.中国骨伤,2014,27:385-389.
16 李军,吴家昌,蒋勇,等.椎体成形术与椎体后凸成形术治疗椎体压缩性骨折疗效的Meta分析.中国矫形外科杂志,2014,22:696-698.
17 Ruiz Santiago F,Santiago Chinchilla A,Guzmán lvarez L,et al.Comparative review of vertebroplasty and kyphoplasty.World J Radiol,2014,6:329-343.
18 刘伟,郑君涛,马原,等.不同容量骨水泥用于经皮穿刺椎体成形术的疗效评价.中国矫形外科杂志,2011,19:1394.
19 刘展亮,张惠城,陈嘉裕,等.经皮椎体成形术中骨水泥注射量与疗效的关系.广东医学,2010,31:44.
20 钟远鸣,付拴虎,张家立,等.经皮穿刺椎体成形术中骨水泥渗漏的原因及预防.中国矫形外科杂志,2014,22:294-296.
2 Ruiz Santiago F,Santiago Chinchilla A,Guzmán L,et al.Comparative review of vertebroplasty and kyphoplasty.World J Radiol,2014,6:329-343.
3 王翀,李京,田征,等.经皮椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的Meta分析.中国矫形外科杂志,2014,22:493-495.
4 Han S,Park HS,Pee YH,et al.The clinical characteristics of lower lumbar osteoporotic compression fractures treated by percutaneous vertebroplasty:a comparative analysis of 120 cases.Korean J Spine,2013,10:221-226.
5 徐荣明,廖旭昱.合理运用椎体成形术与后凸成形术.中国骨伤,2010,23:723-725.
6 王建儒,张奎渤,刘辉,等.经皮椎体后凸成形术术中不同辐射防护距离的对比研究.中国脊柱脊髓杂志,2014,24:417-419.
7 Baroda G,Crookshank M,Bohner M.High-viscosity cement significantly enhances uniformity of cement filling in vertebroplasty:an experimental model and study on cement leakage.Spine,2006,31:2562-2568.
8 Lee BJ,Lee SR,Yoo TY.Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate:a case report.Spine,2002,27:419-422.
9 Legroux-Gerot I,Lormeau C,Boutry N,et al.Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.Clin Rheumatol,2004,23:310-317.
10 Patel AA,Vaccaro AR,Martyak GG,et al.Neurologic decit following percutaneous vertebral stabilization.Spine,2007,32:1728-1734.
11 Harrington KD.Major neurological complications following percutaneous vertebroplasty with polymethylmethacrylate:a case report.J Bone Joint Surg Am,2001,83:1070-1073.
12 Lim SH,Kim H,Kim HK,et al.Multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty.Eur J Cardiothorac Surg,2008,33:510-512.
13 Son KH,Chung JH,Sun K,et al.Cardiac perforation and tricuspid regurgitation as a complication of percutaneous vertebroplasty.Eur J Cardiothorac Surg,2008,33:508-509.
14 陈惠国,张喆,梁海萍,等.椎体后凸成形术治疗骨质疏松性椎体骨折中期疗效及并发症的临床观察.中国骨伤,2010,23:743-745.
15 吴耀,王峰,周建强,等.经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体骨折的临床疗效分析.中国骨伤,2014,27:385-389.
16 李军,吴家昌,蒋勇,等.椎体成形术与椎体后凸成形术治疗椎体压缩性骨折疗效的Meta分析.中国矫形外科杂志,2014,22:696-698.
17 Ruiz Santiago F,Santiago Chinchilla A,Guzmán lvarez L,et al.Comparative review of vertebroplasty and kyphoplasty.World J Radiol,2014,6:329-343.
18 刘伟,郑君涛,马原,等.不同容量骨水泥用于经皮穿刺椎体成形术的疗效评价.中国矫形外科杂志,2011,19:1394.
19 刘展亮,张惠城,陈嘉裕,等.经皮椎体成形术中骨水泥注射量与疗效的关系.广东医学,2010,31:44.
20 钟远鸣,付拴虎,张家立,等.经皮穿刺椎体成形术中骨水泥渗漏的原因及预防.中国矫形外科杂志,2014,22:294-296.
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